加强基本功训练提高学生自学能力 ──农村中医大专班小结

贵阳中医学院首届农村中医大专班迄今已开办 2年,第 1阶段的课堂理论教学已基本完成,即将进入第 2阶段的临床实习。     

口三针滞针牵拉法治疗顽固性面瘫面神经功能指数评价

目的:探寻治疗顽固性面瘫口角歪斜的有效针刺手法。方法:将101例顽固性面瘫患者随机分为观察组(48例)、对照组(53例)。两组在针刺患侧攒竹、四白、颊车、牵正的基础上,同取患侧口三针(地仓、口禾髎、夹承浆),观察组采用滞针牵拉法,对照组采用常规刺法,每天1次,10天为一疗程,观察2个疗程后面神经功能指数(FNFI)的变化。结果:治疗后两组FNFI均显著升高(均P0.01),且观察组优于对照组(P0.01),观察组面神经功能基本恢复率为87.5%(42/48),优于对照组的67.9%(36/53)(P0.05)。结论:口三针滞针牵拉法是治疗顽固性面瘫口角歪斜的较佳方法。     

Spred2 inhibits TGF‐β1‐induced urokinase type plasminogen activator expression,cell motility and epithelial mesenchymal transition

TGF‐β1 is a potent inductor of malignance in cancer cells. TGF‐β1 stimulates the expression of extracellular matrix degrading proteases, cell migration and it is also involved in the epithelial‐mesenchymal transition (EMT). In the present work, we analyzed the role of Spred2 in the urokinase‐type plasminogen activator (uPA) stimulation, EMT and cell migration by TGF‐β1. We found that both the expression of mRNA and the protein level of Spred2 were lower in transformed keratinocytes PDV compared with immortalized keratinocytes MCA‐3D. The transient ectopic expression of Spred2 in PDV cells inhibited the TGF‐β1‐transactivated SRE‐Luc reporter which is related with the ERK1,2 signal. The stable ectopic expression of Spred2 in PDV cells (SP cells) led to the loss of ERK 1,2 activation by TGF‐β1, although Smad2 activation was not affected, and the knockdown of Spred2 enhanced the activation of ERK1,2 signal by TGF‐β1. The increment of uPA expression induced by TGF‐β1 was suppressed in SP cells. In contrast, the stimulus on PAI‐1 expression was not affected and comparable to parental PDV cells. SP cells under TGF‐β1 treatment were unable to display the EMT, since the overexpression of Spred2 abolished the TGF‐β1‐induced disruption of the E‐cadherin cell to cell interactions, reorganization of the actin cytoskeleton and upregulation of the mesenchymal marker vimentin. Finally, SP cells could not respond to the TGF‐β1 stimulus on cell migration. Taken together, the data in the present study suggests that Spred2 is a regulator of TGF‐β1‐induced malignance in transformed keratinocytes.     

Ernährungstherapie nicht nur bei kindlichen Kopfschmerzen

Food intolerance is a well-known factor in functional headache in children. Severe migraine in children can be significantly mitigated by a strict diet. But in the long term, a simpler nutritional change seems to be more appropriate in order to achieve a long-lasting influence on children's headache. A nutritional change of at least 6 weeks' duration should reduce the headache frequency and intensity in the range of 50 % or more in order to be defined as successful. Not only migraine, but also tension-type headache respond in a relevant dimension to nutritional treatment. In case of higher migraine frequency combined with allergic comorbidity, the efficacy of the nutritional regime seems to be even more pronounced. In daily counselling, a combination of written information and a short personal explanation seems to represent a practicable procedure.     

原发性高血压患者左室肥厚与内皮功能改变间关系的超声研究

目的　研究原发性高血压 (EH)患者左室肥厚 (L VH)与内皮功能改变间的关系。方法　超声心动图了解 55例无并发症的 EH患者和 2 0例正常人的心脏结构功能 ,利用高分辨超声技术观察受检者的肱动脉充血后反应性扩张 (DTRH)和含服硝酸甘油后血管内径的变化 (DTNG)。结果　 L VH (2 4/ 55)和非 L VH (3 1/ 55)患者的 DTRH均较正常组减小 ,且前者较后者的 DTRH进一步显著减小 [(4.18± 2 .12 ) % vs (8.2 4± 1.65) % ,P<0 .0 0 0 1]、左室质量指数 (L VMI)增大 [(154.81± 2 8.3 1) g/ m2 vs (98.2 9± 15.76) g/ m2 ,P<0 .0 0 0 1] ,而 DTNG及年龄、血压、血脂、血糖等无显著性差异。单因素相关分析显示 :EH患者的 L VMI与 DTRH呈负相关 (r=-0 .59,P<0 .0 0 0 1)、与舒张压 (DBP)及平均压 (MBP)呈正相关 (r=0 .2 8、 0 .3 0 ,P<0 .0 5) ,但多元回归分析表明L VMI仅与 DTRH有良好相关性。结论　 EH患者左室肥厚与血管内皮功能减退 (ED)改变密切相关 ,ED可能不依赖血压独立参与左室肥厚的发生发展过程     

Clinical Implications of t(11;14) in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation

Conventional cytogenetic analyses and fluorescent in situ hybridization (FISH) are helpful for stratifying patients with multiple myeloma (MM) into high-risk [t(4;14), t(14;16), and/or del 17p] and standard-risk [t(11;14)] categories. However, the prognosis of patients with MM treated with autologous stem cell transplantation (ASCT) stratified according to these categories remains unclear. This retrospective observational study analyzed 97 patients with MM who received a single, planned ASCT after treatment with 200 mg/m² melphalan between 2001 and 2011. The patients were grouped according to chromosomal abnormality, including t(11;14) (n?=?45), t(4;14) (n?=?31), del 17p (n?=?10), t(11;14) with del 17p (n?=?7), and t(4;14) with del 17p (n?=?4). Median overall survival (OS) of the t(11;14) group (64.1 months) was not significantly different from that of the t(4;14) group (not reached), but it was significantly longer than that of the del 17p group (23.0 months; P?=?.002). G-banding revealed that the median OS of the t(11;14) group with additional chromosomal abnormalities (ACAs) (46.2 months) was significantly shorter than that of the t(11;14) group without ACAs (not reached; P?=?.005) and the t(4;14) group (not reached; P?=?.010). These findings highlight the importance of G-banding in patients with t(11;14) MM.     

3203例胎儿的产前21-三体综合征超声筛查

目的 建立超声检测胎儿颈部软组织厚度(nuchal skinfold thickness，NT)的正常参考值，探讨该项指标在产前检出染色体异常中21-三体胎儿的价值。方法 经腹部超声测量3203例中晚孕期胎儿颈部软组织厚度，并进行统计分析。结果 初步得出12-40孕周胎儿NT的参考值范围，应用该项指标超声检测21-三体胎儿，其敏感性为66．67％，特异性为95．06％，准确性为95．00％。结论 NT超声测值对21-三体胎儿的筛查有重要参考价值。     

Evidence for monoaminergic involvement in triadimefon-induced hyperactivity

Triadimefon is a triazole fungicide that produces hyperactivity in both mice and rats similar to that seen following administration of compounds with catecholaminergic activity (e.g., d-amphetamine). To determine whether the triadimefon-induced hyperactivity is due to an action on CNS catecholaminergic systems, we evaluated the effects of combined treatment of triadimefon with either the tyrosine hydroxlase inhibitor d,l--methyl-p-tyrosine methyl ester HCl (MPT) or the amine depletor reserpine. Adult male Long-Evans hooded rats, approximately 70 days of age were used. Dosage-effect functions were determined for MPT (0–200 mg/kg IP), reserpine (0–2.5 mg/kg IP), d-amphetamine (0–3 mg/kg IP), and methylphenidate (0–40 mg/kg IP). Motor activity was measured as photocell interruptions in figure-eight mazes. The interaction between triadimefon and MPT was determined with the following groups: 1) vehicle control; 2) 200 mg/kg triadimefon PO; 3) 100 mg/kg MPT; and 4) both MPT and triadimefon. A similar design was used to determine the interaction between triadimefon and reserpine (0.62 mg/kg), MPT and d-amphetamine (1.5 mg/kg), and reserpine and methylphenidate (5.0 mg/kg). In the first experiment MPT did not block the increased motor activity produced by triadimefon (i.e., both triadimefon alone and MPT in combination with triadimefon produced significant increases in motor activity). MPT did, however, block d-amphetamine-induced hyperactivity. Since MPT did not antagonize the effect of triadimefon, these data suggest that increased motor activity produced by triadimefon is not mediated through release of newly synthesized catecholamines. In contrast, pretreatment with reserpine blocked the hyperactivity induced by both triadimefon and methylphenidate, which suggests that triadimefon-induced hyperactivity may be due to an interaction with CNS catecholamines stored in reserpine-sensitive pools.The research described in this article has been reviewed by the Health Effects Research Laboratory, US Environmental Protection Agency, and approved for publication. Approval does not signify that the contents necessarily reflect the views and policies of the Agency nor does mention of trade names or commercial products constitute endorsement or recommendation for use. Presented in part at the Annual Meeting of the Society for Neuroscience, New Orleans, LA, November, 1987     

Survivin、bcl-2在乳腺癌组织中的表达及其意义

【目的】探讨survivin、bcl-2在乳腺癌组织中的表达及其意义。【方法】用免疫组化法,检测乳腺癌组36例、乳腺癌前病变组43例（其中乳腺不典型增生21例,乳腺单纯性增生22例）,正常乳腺组20例的survivin和bcl-2蛋白表达的强度,并进行定量计分分析。【结果】乳腺癌组、乳腺癌前病变组、正常乳腺组的survivin蛋白表达阳性率分别为：61．11％、37．21％和10．00％,其间比较差异有显著性（P〈0．05）;survivin蛋白表达分值分别为1．03±1．05、0．50±0．74和0．25±0．55,其阳性率及计分值随乳腺组织恶性程度加重而增加（P〈0．05）。bcl-2蛋白表达阳性率分别为：47．22％、27．91％和15．00％,bcl-2蛋白表达分值分别为：0．80±1．01、0．41±0．69和0．20±0．52,随乳腺组织恶性程度加重而阳性表达率和分值也随之增加（P〈0．05）;但乳腺癌组survivin蛋白表达与bcl-2蛋白表达间无相关性（rs为0．308）（P〉0．05）。【结论】乳腺组织survivin和bcl-2蛋白的过度表达预示着组织恶变。     

Effect of digoxin on coronary blood flow and myocardial oxygen consumption in patients with chronic coronary artery disease

In 10 patients with chronic coronary artery disease and without clinical evidence of congestive heart failure, the effects of 1.0 mg of digoxin intravenously on systemic hemodynamics, coronary blood flow, myocardial oxygen consumption and myocardial lactate extraction were studied both at rest and during atrial pacing. Atrial stimulation at a rate just below the threshold for angina led to a significant decrease in left ventricular enddiastolic pressure, from 10.6 ± 1.6 to 7.1 ± 0.8 mm Hg, associated with a significant decrease in left ventricular stroke work index per beat, from 76.7 ± 5.11 to 40.3 ± 4.01 g-m/m². After digoxin, nearly identical results in stroke work index could be observed at rest and during stimulation (75.2 ± 6.74 and 44.1 ± 5.92, respectively). However, left ventricular enddiastolic pressure decreased significantly before and during atrial stimulation (8.1 ± 1.29 and 4.7 ± 1.09 mm Hg, respectively). Cardiac index decreased from 3.08 ± 0.20 to 2.73 ±0.17 liters/min per m² at rest but during pacing it no longer differed before and after digoxin (3.17 ± 0.22 and 3.10 ± 0.20 liters/min per m², respectively). Myocardial oxygen consumption and lactate extraction remained unchanged after digoxin both at rest and during atrial pacing.It is concluded that some deficiency in left ventricular function is present in patients with chronic coronary artery disease even without clinical evidence of congestive heart failure. Digoxin improves left ventricular performance at rest and during stress conditions. An expected increase in myocardial oxygen consumption due to enhanced contractility is completely counterbalanced, probably by a decrease in left ventricular volume after digoxin.